Morcos Bernab, DMD
Individual provider Active NPI Dentist · Woodridge, IL
NPI 1801635610 · NPPES record last updated May 21, 2024
Key facts
- NPI
- 1801635610
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Dentist 122300000X
- License
- 019.035066 (IL)
- Practice address
- 1309 Lancaster LN
Woodridge, IL 60517-7581 - Phone
- (630) 642-4405
- NPI assigned
- May 21, 2024
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 019.035066 | IL | MD | Dentist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 019.035066 | IL | Yes |
Addresses
Primary practice location
1309 Lancaster LN
Woodridge, IL 60517-7581
Mailing address
1309 Lancaster LN
Woodridge, IL 60517-7581
Phone (630) 642-4405
Other providers in Woodridge, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 21, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.